Annual session brings renewed Code activity
On Jan. 1, 2009, the latest version of the Code will be in effect for use on all dental claims, including those submitted on the ADA Dental Claim Form or via the HIPAA (Health Insurance Portability and Accountability Act) standard electronic claim transaction. The Council on Dental Benefit Programs has responsibility representing the interests of all dentists during deliberations of the Code Revision Committee, which is the body that maintains the Code.
CRC activity is already under way for the next version of the Code. This two-year process relies on requests for changes coming from members of the dental community, particularly dentists in daily practice. Information about the process is available on ADA.org (www.ada.org/goto/dentalcode) where dentists can also learn about the guidelines for change request submission and review, review the timetable for request submission and CRC meetings, and download change request forms. Closing dates for submissions are April 1, 2009, and Oct. 1, 2009. The CRC plans to complete its work by mid-2010.
CDBP is responsible for the technical content of the Code, which is published by the ADA in the CDT manual. The latest edition of the manual, CDT 2009/2010, is currently being shipped for orders placed through the ADA Catalog. This edition features an expanded question-and-answer chapter and includes CDBP's perspective on how the Code can be used to document services delivered on patients' records and claims.
Because it is not possible to anticipate all possible questions about the Code or wait until a new edition of the CDT manual is published to post new information, a new page dedicated to common questions and answers about the Code and the ADA Dental Claim Form is now available on ADA.org at www.ada.org/goto/dentalcode. The page will be updated monthly and will archive past months' questions and answers.
Information from the CDT manual also supports two other CDBP initiatives, both designed to help dentists and their staff better understand how to use the Code in their daily practice.
The Code: Your Gateway to Accuracy is a half-day intensive interactive session prepared by the council that features coding scenarios arising from actual clinical cases. This workshop was first created in 1999 and is updated with the introduction of each new version of the Code. The latest version was introduced at the 2008 annual session. In addition to discussing what is in the newest version of the Code, the council added two new sections: a discussion of how to identify possible misuses of the Code by third-party payers and guidance on claim submission to a patient's medical benefit plan.
Code workshops are delivered at sessions sponsored by dental organizations such as state and local dental societies. Arrangements can be made through the ADA's Center for Continuing Education and Lifelong Learning. Presentations are made by CDBP members who participated in the Code's maintenance process; the workshops also include an interactive discussion.
The council also recognizes that not every dentist or member of a practice staff will have the opportunity to participate in a workshop. To fill this gap, a publication titled The CDT Companion complements and builds on information contained in both the CDT manual and in code workshops.
The second edition of the Companion includes complex clinical coding scenarios and a new chapter addressing potential third-party payer Code misuse. Dentists who currently file, or are considering filing, claims against a patient's medical benefit plan can consult the revised and expanded chapter on medical claim filing. Also featured are 111 tables that cross-reference dental procedure codes with medical procedure and diagnosis codes that are required on claims filed against a medical benefit plan.
For answers to questions about any of these programs, ADA members can call the ADA member Service Center toll-free. Nonmembers can call 1-312-440-2500. To order any of the Code related publications, call 1-800-947-4746.